Tab. 1
Sample explanations for Dupuytren contracture explained in the two learning conditions
|
Integrated Basic Science Group |
|
Dupuytren contracture presents as painless nodular thickenings of the palmar aponeurosis that adheres to the skin. No pain is associated with the disease since the nerves of the hand which transmit pain information to the brain are not affected. Gradually, thickening and progressive shortening (contracture) of the longitudinal bands produces raised ridges in the palm of the hand. Fibrosis degeneration and shortening of the longitudinal bands causes partial flexion of the affected fingers at the metacarpophalangeal and proximal interphalangeal joints. With progressive disease, a flexion deformity will develop and as a result the patient will report an inability to fully extend the affected fingers at the metacarpophalangeal and proximal interphalangeal joints. The flexion deformity is caused by the shortening of the longitudinal bands of the palmar aponeurosis. The flexion deformity limits the person’s ability to fully open their hand, making it difficult to grasp large objects. In Dupuytren contracture there are no sensory changes observed in the hand. This is because the contracture does not affect the nerves of the hand that are responsible for supplying sensory information to the skin |
|
Clinical Science Only Group |
|
Dupuytren contracture presents as painless nodular thickenings that adhere to the skin. Gradually, patients present with raised ridges in the palmar skin that extend from the proximal part of the hand to the base of the fingers. In patients’ affected fingers, partial flexion occurs at the metacarpophalangeal and proximal interphalangeal joints. With progressive disease, a flexion deformity can develop and patients will report an inability to fully extend the affected fingers at the metacarpophalangeal and proximal interphalangeal joints. The disease can occur in both hands but is generally not symmetric in severity. The ring finger is most commonly involved followed by the little finger. Patients typically have a difficult time grasping large objects. There are no sensory changes observed in this disease |
Fig. 1
Likert scale used to score the diagnostic justification test
Tab. 2
Average scores on the diagnostic accuracy, memory, and diagnostic justification tests
|
Immediate |
Delayed | ||||
|---|---|---|---|---|---|
|
Mean |
SD |
Mean |
SD | ||
|
Diagnostic accuracy |
BaSci group (n = 22) |
0.73 |
0.15 |
0.65 |
0.24 |
|
CS group (n = 21) |
0.58 |
0.19 |
0.46 |
0.14 | |
|
Memory |
BaSci group (n = 22) |
0.66 |
0.17 |
0.58 |
0.17 |
|
CS group (n = 21) |
0.47 |
0.11 |
0.51 |
0.11 | |
|
Diagnostic justification |
BaSci group (n = 22) |
– |
– |
3.9 |
1.04 |
|
CS group (n = 21) |
– |
– |
3.1 |
0.96 | |